Table 3.
Univariate and multivariable analysis of risk factors for graft loss due to hepatic artery thrombosis within 90 days of liver transplantation
| Univariate analysis (OR, 95% CI) | Multivariable analysis (OR, 95% CI) | p-values for multivariable model | |
|---|---|---|---|
|
| |||
| Recipient Characteristics | |||
|
| |||
| Age at transplant, mean years | 0.98 (0.98–0.99) | 0.98 (0.97–0.99) | 0.001 |
|
| |||
| Male gender | 0.94 (0.79–1.11) | ||
|
| |||
| African American race | 1.05 (0.81–1.36) | ||
|
| |||
| Diabetes | 0.78 (0.64–0.95) | 0.88 (0.68–1.14) | 0.318 |
|
| |||
| On dialysis at transplantation | 0.79 (0.60–1.04) | ||
|
| |||
| BMI, mean kg/m2 | 1.01 (0.99–1.02) | ||
|
| |||
| Etiology of liver disease | |||
|
| |||
| Alcoholic liver disease | 0.91 (0.70–1.17) | ||
|
| |||
| Autoimmune disease | 1.37 (0.85–2.12) | ||
|
| |||
| Cholestatic disease | 1.24 (0.94–1.64) | ||
|
| |||
| Hepatitis B | 1.07 (0.63–1.82) | ||
|
| |||
| Hepatitis C | 0.97 (0.82–1.16) | ||
|
| |||
| NASH | 1.14 (0.90–1.44) | ||
|
| |||
| Severity of Liver Disease | |||
|
| |||
| HCC | 0.82 (0.67–1.01) | ||
|
| |||
| Ascites grade > 2 at transplant | 0.90 (0.85–1.07) | ||
|
| |||
| HE > 2 at transplant | 1.08 (0.85–1.39) | ||
|
| |||
| Laboratory values | |||
|
| |||
| Serum bilirubin, mg/dL | 0.99 (0.98–1.00) | ||
|
| |||
| INR | 0.88 (0.79–0.97) | 0.87 (0.76–0.98) | 0.027 |
|
| |||
| Serum albumin, g/dL | 0.97 (0.87–1.08) | ||
|
| |||
| Creatinine, g/dL | 0.92 (0.86–0.98) | 0.91 (0.83–0.99) | 0.035 |
|
| |||
| Serum sodium, mEq/L | 0.99 (0.98–1.01) | ||
|
| |||
| Donor characteristics | |||
|
| |||
| Male donor | 0.52 (0.45–0.61) | 0.53 (0.44–0.64) | <0.001 |
|
| |||
| High DRI | 1.99 (1.69–2.35) | --- | |
|
| |||
| Macrovesicular fat content of donor liver | 1.00 (0.96–1.01) | ||
|
| |||
| Surgical characteristics | |||
|
| |||
| Heparin use at cross clamp | 0.52 (0.43–0.63) | 0.61 (0.47–0.79) | 0.002 |
|
| |||
| DDAVP use | 0.90 (0.74–1.10) | ||
|
| |||
| Thrombosis | |||
|
| |||
| PVT and HRD# | 3.84 (2.83–5.21) | 3.56 (2.52–5.02) | <0.001 |
| No PVT and HRD# | 2.00 (1.67–2.39) | 2.25 (1.49–3.42) | <0.001 |
| PVT and SRD# | 1.95 (1.32–2.89) | 1.71 (1.36–2.15) | <0.001 |
| PVT | 1.93 (1.53–2.43) | --- | |
BMI=Body mass index; CI=Confidence interval; CIT=Cold ischemia time;
CMV=Cytomegalovirus; DRI=Donor risk index; DDAVP=Desmopressin; HE=Hepatic encephalopathy; HCC=Hepatocellular carcinoma; HRD=High-risk donor (DRI>1.7); INR=International normalized ratio; NASH=Non-alcoholic steatohepatitis; NS=Not significant; PVT=Portal vein thrombosis; SRD=Standard-risk donor (DRI≤1.7)
compared to reference group of no PVT and NRD
Final variables included in the logistic regression model included recipient age at transplantation, gender, BMI, African American race, diabetes, HCC, HCV, cholestatic liver disease, autoimmune hepatitis, encephalopathy (which was divided into those with encephalopathy score >2), ascites (similarly divided by score > 2), laboratories at transplantation (INR, bilirubin, creatinine, albumin, sodium), PVT], operative (heparin use at cross clamp, and donor factors (age, gender, HRD, DDAVP). Interaction terms for PVT and HRD, HCV and donor age, NASH and BMI and NASH and diabetes were included in the final model. Possible covariates for the PVT-HRD interaction variable included PVT with HRD, no PVT with HRD, as well as PVT with SRD.